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Pan P, Liu T, Li W, Bo Y. Tracheal Penetrating Injury and Airway Management: A Review of Two Cases. J Cardiothorac Vasc Anesth 2024; 38:1734-1737. [PMID: 38876808 DOI: 10.1053/j.jvca.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/02/2024] [Accepted: 05/11/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Peng Pan
- Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang Key Laboratory of Anesthesiology and Intensive Care Research & Key Laboratory for Basic Theory and Application of Anesthesiology of the Heilongjiang Higher Education Institution, Harbin, China
| | - Tianhua Liu
- Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang Key Laboratory of Anesthesiology and Intensive Care Research & Key Laboratory for Basic Theory and Application of Anesthesiology of the Heilongjiang Higher Education Institution, Harbin, China
| | - Wenzhi Li
- Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang Key Laboratory of Anesthesiology and Intensive Care Research & Key Laboratory for Basic Theory and Application of Anesthesiology of the Heilongjiang Higher Education Institution, Harbin, China
| | - Yulong Bo
- Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang Key Laboratory of Anesthesiology and Intensive Care Research & Key Laboratory for Basic Theory and Application of Anesthesiology of the Heilongjiang Higher Education Institution, Harbin, China.
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Greco M, Caruso PF, Angelotti G, Aceto R, Coppalini G, Martinetti N, Albini M, Bash LD, Carvello M, Piccioni F, Monzani R, Montorsi M, Cecconi M. REVersal of nEuromusculAr bLocking Agents in Patients Undergoing General Anaesthesia (REVEAL Study). J Clin Med 2023; 12:jcm12020563. [PMID: 36675492 PMCID: PMC9866312 DOI: 10.3390/jcm12020563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Background: Neuromuscular blocking agent (NMBA) monitoring and reversals are key to avoiding residual curarization and improving patient outcomes. Sugammadex is a NMBA reversal with favorable pharmacological properties. There is a lack of real-world data detailing how the diffusion of sugammadex affects anesthetic monitoring and practice. Methods: We conducted an electronic health record analysis study, including all adult surgical patients undergoing general anesthesia with orotracheal intubation, from January 2016 to December 2019, to describe changes and temporal trends of NMBAs and NMBA reversals administration. Results: From an initial population of 115,046 surgeries, we included 37,882 procedures, with 24,583 (64.9%) treated with spontaneous recovery from neuromuscular block and 13,299 (35.1%) with NMBA reversals. NMBA reversals use doubled over 4 years from 25.5% to 42.5%, mainly driven by sugammadex use, which increased from 17.8% to 38.3%. Rocuronium increased from 58.6% (2016) to 94.5% (2019). Factors associated with NMBA reversal use in the multivariable analysis were severe obesity (OR 3.33 for class II and OR 11.4 for class III obesity, p-value < 0.001), and high ASA score (OR 1.47 for ASA III). Among comorbidities, OSAS, asthma, and other respiratory diseases showed the strongest association with NMBA reversal administration. Conclusions: Unrestricted availability of sugammadex led to a considerable increase in pharmacological NMBA reversal, with rocuronium use also rising. More research is needed to determine how unrestricted and safer NMBA reversal affects anesthesia intraoperative monitoring and practice.
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Affiliation(s)
- Massimiliano Greco
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Anaesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Correspondence:
| | - Pier Francesco Caruso
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | | | - Romina Aceto
- Department of Anaesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Giacomo Coppalini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Anaesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Nicolò Martinetti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Anaesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Marco Albini
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | | | - Michele Carvello
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Surgery, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Federico Piccioni
- Department of Anaesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Roberta Monzani
- Department of Anaesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Marco Montorsi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Surgery, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Anaesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
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